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2. Evolocumab and clinical outcomes in patients with cardiovascular disease

Author

Sabatine, MS, Giugliano, RP, Keech, AC, Honarpour, N, Wiviott, SD, Murphy, SA, Kuder, JF, Wang, H, Liu, T, Wasserman, SM, Sever, PS, Pedersen, TR, Fish, MP, Abrahamsen, TE, Im, K, Kanevsky, E, Bonaca, MP, Lira Pineda, A, Hanlon, K, Knusel, B, Somaratne, R, Kurtz, C, Scott, R, Accini Mendoza, JL, Amerena, J, Badariene, J, Burgess, L, Ceska, R, Charng, MJ, Choi, D, Cobos, JL, Dan, GA, De Ferrari, GM, Deedwania, PC, Chopra, VK, Erglis, A, Ezhov, MV, Ferreira, J, Filipová, S, Gaciong, ZA, Pasierski, T, Georgiev, BG, Gonzalez-Galvez, G, Gouni-Berthold, I, Schäufele, T, Hirayama, A, Huber, K, Rammer, M, Kjaerulf Jensen, H, Wermuth, S, Jiang, L, Jukema, JW, Kraydashenko, O, Leiter, LA, Lewis, BS, López-Miranda, J, Lorenzatti, AJ, Mach, F, McAdam, B, Nilsson, L, Olsson, A, Rallidis, L, Rogelio, GG, Kerr Saraiva, JF, Scheen, A, Schiele, F, Connolly, D, Siu, CW, Tay, L, Thorgeirsson, G, Tikkanen, MJ, Tokgozoglu, SL, Toth, K, Viigimaa, M, Wan Ahmad, WA, Hennekens, CH, Andreotti, F, Baigent, C, Brown, WV, Davis, BR, Newcomer, JW, Wood, SK, LaRosa, J, Ansell, B, Lowe, C, Zahn, L, Awtry, E, Berger, C, Croce, K, Desai, A, Gelfand, E, Ho, C, Leeman, D, Link, M, Norden, A, Pande, A, Rost, N, Ruberg, F, Silverman, S, and Singhal, A

Abstract

© 2017 Massachusetts Medical Society. BACKGROUND Evolocumab is a monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type 9 (PCSK9) and lowers low-density lipoprotein (LDL) cholesterol levels by approximately 60%. Whether it prevents cardiovascular events is uncertain. METHODS We conducted a randomized, double-blind, placebo-controlled trial involving 27,564 patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of 70 mg per deciliter (1.8 mmol per liter) or higher who were receiving statin therapy. Patients were randomly assigned to receive evolocumab (either 140 mg every 2 weeks or 420 mg monthly) or matching placebo as subcutaneous injections. The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. The key secondary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. The median duration of follow-up was 2.2 years. RESULTS At 48 weeks, the least-squares mean percentage reduction in LDL cholesterol levels with evolocumab, as compared with placebo, was 59%, from a median baseline value of 92 mg per deciliter (2.4 mmol per liter) to 30 mg per deciliter (0.78 mmol per liter) (P

Published
2017
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3. Evolocumab and clinical outcomes in patients with cardiovascular disease

Author

Sabatine, Marc S., Giugliano, Robert P., Keech, Anthony C., Honarpour, Narimon, Wiviott, Stephen D., Murphy, Sabina A., Kuder, Julia F., Wang, Huei, Liu, Thomas, Wasserman, Scott M., Sever, Peter S., Pedersen, Fish MP, Terje R., Abrahamsen, Te, Im, K, Kanevsky, E, Bonaca, Mp, Lira Pineda, A, Hanlon, K, Knusel, B, Somaratne, R, Kurtz, C, Scott, R, Accini Mendoza JL, Amerena, J, Badariene, J, Burgess, L, Ceska, R, Charng, Mj, Choi, D, Cobos, Jl, Dan, Ga, De Ferrari GM, Deedwania, Pc, Chopra, Vk, Erglis, A, Ezhov, Mv, Ferreira, J, Filipová, S, Gaciong, Za, Pasierski, T, Georgiev, Bg, Gonzalez-Galvez, G, Gouni-Berthold, I, Schäufele, T, Hirayama, A, Huber, K, Rammer, M, Kjaerulf Jensen, H, Wermuth, S, Jiang, L, Jukema, Jw, Kraydashenko, O, Leiter, La, Lewis, Bs, López-Miranda, J, Lorenzatti, Aj, Mach, F, Mcadam, B, Nilsson, L, Olsson, Å, Rallidis, L, Rogelio, Gg, Kerr Saraiva JF, Scheen, A, Schiele, F, Scott, Rs, Connolly, D, Siu, Cw, Tay, L, Thorgeirsson, G, Tikkanen, Mj, Tokgozoglu, Sl, Toth, K, Viigimaa, M, Wan Ahmad WA, Hennekens, Ch, Andreotti, F, Baigent, C, Brown, Wv, Davis, Br, Newcomer, Jw, Wood, Sk, Larosa, J, Ansell, B, Olsson, A, Lowe, C, Zahn, L, Awtry, E, Berger, C, Croce, K, Desai, A, Gelfand, E, Ho, C, Leeman, D, Link, M, Norden, A, Pande, A, Rost, N, Ruberg, F, Silverman, S, Singhal, A, Vita, J, Mackinnon, I, Vogel, Dr, Leon de la Fuente, R, Perna, E, Amuchastegui, M, Pacora, F, Hershson, A, Blumberg, E, Glenny, Ja, Colombo, H, Cuadrado, Ja, Nicolosi, L, Rojas, Cg, Ulla, Mr, Hasbani, Eg, Cuneo, C, Lopez Santi RG, Sanabria, Hd, Hrabar, A, Lozada, A, Begg, A, Lehman, S, Wittert, G, Juergens, C, Kostner, K, Beltrame, J, Simpson, R, Sinhal, A, Adams, M, Kritharides, L, Roberts Thomson, P, Cross, D, Thompson, P, Van Gaal, W, Cox, N, Farshid, A, Hammett, C, Garrahy, P, Prasan, A, Horrigan, M, Ebenbichler, C, Hanusch, U, Prager, R, Schernthaner, G, Luger, A, Siostrzonek, P, Toplak, H, Bergler-Klein, J, Paulweber, B, Sinzinger, H, Buysschaert, I, Thoeng, J, Vandekerckhove, H, Catez, E, Verheye, S, Descamps, O, Hoffer, E, Wollaert, B, Chenu, P, van de Borne, P, De Meulemeester, M, Friart, A, Charlier, F, De Raedt, H, Rietzschel, E, Roelandt, R, Lalmand, J, Tavares Russo LA, Reis, G, Duarte Barbosa EC, Vidotti, Mh, Fernandes Manenti ER, Dutra, O, Leaes, Pe, Rech, Rl, Bertolim Precoma, D, Nicolau, Jc, Amoedo, R, Eliaschewitz, Fg, Pereira, A, Kurtz Lisboa HR, Soares Piegas, L, Cunha Borges JL, Ferreira Rossi PR, Pimentel Filho, P, Bodanese, Lc, de Sa Cunha, R, Moura Jorge JC, Ardito, Wr, Barroso de Souza WK, Hissa, M, Izar, Mc, Manolova, A, Kitova, L, Kinova, E, Tzekova, M, Velchev, V, Tarnovska-Kadreva, R, Gotchev, D, Petrov, I, Raev, D, Trendafilova-Lazarova, D, Yotov, Y, Lazov, P, Rahimi, S, St Amour, E, Constance, C, Pesant, Y, Hess, A, Anderson, T, Sussex, B, Henein, S, Tsoukas, G, Pandey, As, Bergeron, J, Hart, R, Gosselin, G, Chehayeb, R, Hamet, P, Hartleib, M, Mukherjee, A, Halperin, F, Petrella, R, Bhargava, R, Lonn, E, Sabbah, E, Bata, I, Cha, J, Gaudet, D, Chapman, K, Murthy, D, Nigro, F, Rupka, D, Gossard, D, Gupta, M, Dowell, A, Mansour, S, Baass, A, Geadah, C, Huynh, T, Peterson, S, Poirier, P, Sabe-Affaki, G, Vertes, G, Crowley, D, Duchesne, L, Pincetti Jofre CP, Potthoff Cardenas, S, Conejeros Kindel, C, Saavedra Gajardo VA, Lanas Zanetti, F, Sepulveda Varela PA, Stockins Fernandez BA, Li, W, Li, D, Zhao, S, Li, Z, Wang, J, Yang, Y, Zhang, L, Yang, P, Zhang, X, Huang, H, Xue, L, Zheng, Z, Huang, W, Dai, H, Su, H, Zeng, X, Zheng, Y, Tang, Y, Yao, Z, Sun, Y, Du, Y, Ge, Z, Yan, J, Chen, X, Liu, F, Pei, H, Yang, X, Cui, H, Gu, Y, Yang, Z, Li, J, Lian, Y, Cui, Y, Wang, D, Jiang, J, Li, X, Chen, J, Mo, Z, Xu, P, He, Y, Zhou, C, Qu, P, Zhu, Y, Liu, Y, Shen, X, Gao, X, Terront Lozano MA, Moncada Corredor MA, Hernandez Triana, E, Botero Lopez, R, Coronel Arroyo JA, Quintero Baiz AE, Sanchez Vallejo, G, Arana Londoño, C, Molina de Salazar DI, Castellanos Bueno, R, Manzur Jattin, F, Cure Cure CA, Sotomayor Herazo, A, Spinar, J, Hala, T, Machkova, M, Klimsa, Z, Polasek, R, Jerabek, O, Kazdera, P, Pozdisek, Z, Vaclavik, J, Frana, P, Elbl, L, Kucera, D, Kryza, R, Malecha, J, Reichert, P, Sochor, K, Ludka, O, Kellnerova, I, Peterka, K, Zidkova, E, Cech, V, Brabec, T, Fiserova, N, Kvasnicka, J, Rosolova, H, Nemecek, E, Adamkova, V, Dunaj, M, Pojsl, S, Cepelak, M, Podpera, I, Kuchar, L, Rysava, D, Burianova, H, Spinarova, L, Skrobakova, J, Charvat, J, Homza, M, Zemanek, J, Koleckar, P, Karen, I, Krupicka, J, Blaha, V, Matuska, J, Brotanek, J, Cifkova, R, Kuchar, R, Vomacka, Z, Kosek, Z, Hulinsky, V, Krejcova, H, Kuchar, J, Jelinek, Z, Jelinek, P, Markdanner Lindgren, L, Saetre Lihn, A, Korsgaard Thomsen, K, Bronnum-Schou, J, Nielsen, H, Nielsen, T, Egstrup, K, Klausen, Ic, Mickley, H, Hove, J, Jeppesen, J, Melchior, T, Schmidt, Eb, Valter, I, Rosenthal, A, Kaik, J, Kork, A, Alt, I, Strand, J, Nieminen, S, Kahri, J, Suomi, J, Nyman, K, Strandberg, Te, Piippo, T, Savolainen, M, Vikman, S, Pucheu, Y, 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Aldrete Velasco JA, Cardona Muñoz EG, Leiva Pons JL, Perez Alva JC, van der Zwaan, C, Oomen, A, van de Wal, R, Magro, M, Boswijk, D, Janus, C, Groutars, R, Tonino, W, Cornel, Jh, Oude Ophuis, A, Troquay, R, Liem, A, Westendorp, I, Van Hessen, M, Lok, D, De Nooijer, C, Den Hartog, F, Van Beek, E, Bendermacher, P, Jansen, R, Römer, T, Rensing, B, Hersbach, F, Herrman, J, Ladyjanskaia, G, Karalis, I, Linssen, G, Bokern, M, Visman, A, Kooij, A, Monajemi, H, Lieverse, A, Baker, J, Tie, S, Risberg, K, Hysing, J, Pedersen, T, Hoivik, Ho, Norheim, P, Solnor, L, Hovland, A, Kjaernli, T, Jocson, G, Coching, Rm, Batalla, E, Go, A, Habaluyas, R, Barcinas, R, Sy, Ra, Estepar, Ra, Germar, A, Trebacz, J, Szymkowiak, K, Wnetrzak-Michalska, R, Kopaczewski, J, Przekwas-Jaruchowska, M, Kania, G, Zabowka, M, Mirek-Bryniarska, E, Dabrowska, M, Napora, P, Konieczny, M, Spyra, J, Lysek, R, Pijanowski, Z, Grzegorzewski, B, Bednarkiewicz, Z, Kinasz, L, Antkowiak-Piatyszek, K, Stania, K, Szpajer, M, Staneta, P, 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Dobkin, L, Focil, A, Gandy, W, Pasquini, J, Ramos, M, Rodriguez, D, Rosenson, R, Sanford, K, Schlau, A, Snyder, B, Stonesifer, L, Tang, A, De Souza, J, Elam, M, French, J, Guyton, J, Hage Korban, E, Kereiakes, D, King, M, Loh, I, Navarro, J, Simons, R, Tobin, T, Younis, L, Aboufakher, R, Baldari, D, Ballantyne, C, Broughton, R, Eaton, C, Johnston, J, Simon, W, Thomson, S, Vora, K, Youngman, D, Alzohaili, O, Auerbach, E, Brown, C, Burrough, B, Chen, Y, Gilpatrick, M, Landzberg, J, Mitchell, C, Rice, L, Rubenfire, M, Sofley, C, Strobl, D, Atassi, K, Davila, W, Diogo, J, Fagan, T, Joffe, I, Krishna, J, Osea, E, Penny, W, Rowe, W, Shapiro, M, Welker, J, Benton, R, Dobratz, D, Fortuin, F, Graham, J, Henry, B, Kusnick, B, Lutskiy, M, Mcrae, A, Saway, W, Scott, J, Shah, M, Weinberg, B, Zarich, S, Acheatel, R, Case, C, Earl, J, Fernandez, S, Giugliano, G, Handelsman, Y, Hermany, P, Holder, S, Kashyap, M, Khan, A, Lader, E, Peniston, J, Raoof, T, Sacco, J, Shore, K, Spriggs, D, Stringam, S, Tahirkheli, N, Delgado, E, Derian, W, Greenwald, J, Harris, M, Jackson, R, Marhefka, G, Mcelveen, W, Mooss, A, Morris, P, Murray, J, Pearlstein, P, Raisinghani, A, Rezkalla, S, Sakhrani, L, Schreibman, D, Shaoulian, E, Steinsapir, J, Yataco, A, De La Cruz, A, Fredrick, M, Goldenberg, E, Lee, D, Mccullum, K, Mclellan, B, Stephens, L, Wilson, S, Alfieri, A, Mandviwala, M, Orourke, D, Samal, A, Schmedtje, J, Waxman, F, Carhart, R, Clements, B, Dyke, C, Ghali, J, Gruberg, L, Hack, T, Jehle, A, Pogue, B, Schooley, C, and Shifrin, G

Subjects
Male, STATIN THERAPY, 2700 General Medicine, Disease, Cardiovascular, PLACEBO-CONTROLLED TRIAL, Gastroenterology, 0302 clinical medicine, Anticholesteremic Agent, Medicine, Myocardial infarction, 11 Medical and Health Sciences, ddc:616, Incidence, Antibodies, Monoclonal, General Medicine, Cholesterol, Cardiovascular Diseases, Monoclonal, Drug Therapy, Combination, Proprotein Convertase 9, Antibody, Aged, Anticholesteremic Agents, Atherosclerosis, Cholesterol, LDL, Double-Blind Method, Female, Follow-Up Studies, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Hypercholesterolemia, Least-Squares Analysis, Middle Aged, Medicine (all), REDUCING LIPIDS, Human, medicine.medical_specialty, Evinacumab, Clinical Trials and Supportive Activities, PCSK9 INHIBITION, Follow-Up Studie, LDL, 03 medical and health sciences, Drug Therapy, Clinical Research, LDL-C, Least-Squares Analysi, Science & Technology, Unstable angina, PCSK9, medicine.disease, chemistry, Clinical Biochemistry, 030204 cardiovascular system & hematology, Bococizumab, FOURIER Steering Committee and Investigators, Medical and Health Sciences, chemistry.chemical_compound, Antibodies monoclonal, Cardiovascular Disease, 030212 general & internal medicine, Stroke, Humanized, RISK, biology, PCSK9 Inhibitors, 10051 Rheumatology Clinic and Institute of Physical Medicine, Heart Disease, Atherosclerosi, 6.1 Pharmaceuticals, Combination, Cardiology, Life Sciences & Biomedicine, Antibodies, Monoclonal, Humanized, EZETIMIBE, 610 Medicine & health, Antibodies, Medicine, General & Internal, General & Internal Medicine, Internal medicine, CORONARY-HEART-DISEASE, In patient, Heart Disease - Coronary Heart Disease, Alirocumab, Ldl cholesterol, business.industry, Evaluation of treatments and therapeutic interventions, Evolocumab, Good Health and Well Being, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, biology.protein, MODERATE, Hydroxymethylglutaryl-CoA Reductase Inhibitor, business
Abstract

Background Evolocumab is a monoclonal antibody that inhibits proprotein convertase subtilisin–kexin type 9 (PCSK9) and lowers low-density lipoprotein (LDL) cholesterol levels by approximately 60%. Whether it prevents cardiovascular events is uncertain. Methods We conducted a randomized, double-blind, placebo-controlled trial involving 27,564 patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of 70 mg per deciliter (1.8 mmol per liter) or higher who were receiving statin therapy. Patients were randomly assigned to receive evolocumab (either 140 mg every 2 weeks or 420 mg monthly) or matching placebo as subcutaneous injections. The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. The key secondary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. The median duration of follow-up was 2.2 years. Results At 48 weeks, the least-squares mean percentage reduction in LDL cholesterol levels with evolocumab, as compared with placebo, was 59%, from a median baseline value of 92 mg per deciliter (2.4 mmol per liter) to 30 mg per deciliter (0.78 mmol per liter) (P

Published
2017

7. Stratégia kombinovanej antihypertenzívnej liečby.

Author

Filipová, S.

Abstract

High blood pressure (BP) as a symptom as well a as clinical disease is caused by multifactorial processes, e.g. on the basis of various pathophysiological "error" events in maintaining the physiological blood flow regulation. Treatment of hypertension may therefore be effective and long-term efficient only if it affects synchronously the many disturbed regulatory areas which maintain the normal function of the cardiovascular (CV) system (heart, central and peripheral arteries) and various other organs (especially kidneys and central nervous system). The vast majority of hypertensive patients require a combination of at least two antihypertensive agents to reach the target blood pressure. Based on knowledge of the hypertension pathophysiology it is possible to stress 3 basic practical clinical conclusions: (1) It is necessary to diagnose hypertension correctly as soon as possible, stratify, and then start the treatment, while (2) in the hypertension treatment it is a pathophysiologically correct to intervene simultaneously in several potential aetiological positions responsible for the rise and maintenance of elevated BP, (3) this treatment should be at the same time act as preventive protection for systems and organs that are most vulnerable to the effects of high BP. The complex and combined pharmacological antihypertensive treatment is therefore lege artis procedure, on the basis of evidence-based medicine (EBM). The aim of this overview is the drug antihypertensive therapy and the decision making process for monotherapy and combination therapy. It describes the principles of correct choice of drug therapy when combining two or more antihypertensive drugs based on EBM. The article specifically covers various aspects of fixed dual combinations and fixed triple combinations in clinical practice. Since hypertension is the largest risk factor for the current overall mortality and CV mortality in the adult population, it is necessary to understand it scientifically at all levels and clinically and to support this in community and health programmes. [ABSTRACT FROM AUTHOR]

Published
2015

10. Had care of arterial hypertension patients been advanced in 2021?

Author

Vachulová A, Šimková A, and Filipová S

Subjects
Antihypertensive Agents therapeutic use, Blood Pressure, Blood Pressure Determination, Humans, Cardiology, Hypertension complications, Hypertension diagnosis, Hypertension therapy
Abstract

Arterial hypertension (AH) is a very common disease with increasing incidence and prevalence. AH becomes worldwide the main preventable cause of the preventable deaths. Therefore, it is very important to obtain early diagnose and convenient treatment. Still high cardiovascular mortality in Slovakia, where we have a position at the tail compared to other European countries, very closely related to the failure to obtain treatment blood pressure (BP) target ranges. AH rarely occurs in isolation, and often clusters with other CV risk factors such as dyslipidemia and obesity. 2018 ESC/ESH Guidelines for the management of arterial hypertension has brought several new concepts how to manage arterial hypertension. However, it is important to implement the recommendations of the European Society of Cardiology to everyday clinical practice in each country.

Published
2022

11. Stress kardiomyopathy triggered by unusual situation.

Author

Bobocká K, Jurkovičová OG, Líška B, and Filipová S

Subjects
Arrhythmias, Cardiac, Coronary Angiography, Echocardiography, Electrocardiography, Female, Humans, Middle Aged, Myocardial Infarction, Takotsubo Cardiomyopathy diagnostic imaging
Abstract

Stress - “takotsubo” cardiomyopathy - is a reversible mimicking acute myocardial infarction. The trigger is extreme mental or physical stress. The main diagnostic examination is ventriculography with typical left ventricle apical ballooning wall motion abnormality. We present a case report of 63 years old woman, hospitalized at the Department of IV. internal Clinic Medical Faculty and University Hospital Bratislava due to angina. The main trigger was atypical stress situation - urgent need to urinate. On admission, the patients condition was dominated by the hypertension emergency, tachycardia and psychic tension. The ECG on admission revealed the sinus tachycardia and only marked ST elevation in leads I, II, V3-V6. The negative T wave in the leads I, II, V1-V6 was documented on latter ECG. Following the dynamics of troponin levels we assumed the non-STEMI, but due to psychic stress we also considered stress cardiomyopathy. Our patient underwent the coronary angiography and only marginal changes were present. The catecholamine cardiomyopathy with left ventricular apical wall motion abnormality, mild reduction of ejection fraction (48-50 %) and 1st degree of diastolic dysfunction was proved by ventriculography and echocardiography. After the 2 months follow-up, echocardiography confirmed the physiologic finding. This case report points out to the atypical urgent situation that provoked the stress cardiomyopathy.

Published
2020

12. [Occurrence of abnormal late ventricular potentials in myocardial ischemia and the determination of risk of sudden cardiac death in patients after myocardial infarct].

Author

Filipová S, Mikus P, and Cagán S

Subjects
Death, Sudden, Cardiac prevention & control, Humans, Myocardial Infarction complications, Myocardial Infarction therapy, Risk Factors, Death, Sudden, Cardiac etiology, Electrocardiography, Myocardial Infarction physiopathology
Abstract

Background: The crucial step in prevention of sudden cardiac death (SCD) is a method of a precise and most accessible identification of those patients with ischaemic cardiac disease (ICD), especially after MI, who are highly presumptive candidates of malign ventricular arrhythmias. The selection of individuals exposed to risk, and individual judgment of the threat to patients after MI is a complex problem. Patients after MI are endangered by reinfarction, cardiac failure, heart wall rupture and primary ventricular tachyarrhythmia. Stratification of patients exposed to a presumably higher risk of probable new coronary event and malign ventricular arrhythmia with an early decision to intervene, gains practical clinical significance. Similarly, it is important to identify also the patients after MI exposed to lower risk, who need no interventional therapeutical procedure. The cardiologic practice utilizes several examinatory procedures and tests, prevailingly of non-invasive character., Aims and Objectives: The study reviews the latest information on pathophysiology and current level of clinical interpretation of non-invasive ecg procedure from the field of high-resolution electrocardiography including the late ventricular potentials (LVP). The study is aimed at: a) presentation of a review of available information from the field of electrophysiology and clinical electrocardiography and the mechanism of impact of myocardial ischaemia on the existence of high-frequency, but at the same time extremely low-amplitude potentials abnormalities in the course of QRS complex and S-T segment (LVP), b) presentation of a review on the informative value and clinical significance produced by non-invasively detected electrophysiological heterogeneity of myocardium during ischaemia, aiding the short-term and long-term prognosis judgments in patients with ICD, especially after undergoing its most serious form--myocardial infarction. Beside the group analysis the study is also aimed at individual non-invasive judgment of risk of the development of malign ventricular arrhythmias in patients with acute coronary syndromes. (Fig. 3, Ref. 41.)

Published
1996

19. Evaluation of the state of health of subjects with W-P-W syndrome.

Author

Cagán S, Filipová S, and Jurkovicová O

Subjects
Diagnosis, Differential, Electrocardiography, Exercise Test, Humans, Military Personnel, Myocardial Infarction diagnosis, Sports Medicine, Systole, Wolff-Parkinson-White Syndrome diagnosis
Abstract

Topical questions in evaluating the state of health in the least risk-exposed group of subjects with the W-P-W syndrome are dealt with: the recognition of preexcitation, the possibility of confusing the W-P-W syndrome with the postinfarction state, the occurrence of abnormal T waves after suppression of preexcitation, and the ECG dynamics after physical exercise. On the basis of ECG and normal results of non-invasive polygraphic examination (systole phase analysis--systolic time intervals) it is possible to divide the least-risk group of persons with preexcitation (with an otherwise normal heart and without paroxysmal tachycardia) into five subgroups (with growing risk) and to evaluate the ability of a person with preexcitation to engage in sports; to carry out military service etc. The mentioned non-invasive examinations are the basic prerequisites in every subject with the W-P-W syndrome and in symptomatic patients before more detailed electrophysiological examination.

Published
1987

22. Determination of the preexcitation focus in the W-P-W picture by isopotential body-surface mapping.

Author

Cagán S, Filipová S, Jurkovicová O, and Kuchárová L

Subjects
Adolescent, Adult, Female, Heart physiopathology, Humans, Male, Middle Aged, Electrocardiography methods, Wolff-Parkinson-White Syndrome physiopathology
Abstract

Experiences with the determination of the preexcitation focus in 13 patients with W-P-W syndrome aged 18-62 years are presented. The data of ECG mapping from the chest surface and the abdominal wall were processed by computer. For classification of the maps the criteria elaborated by Yamada et al., da Ambroggi et al., and Benson et al. were used. It was possible to determine on their basis the preexcitation focus in all examined subjects, although a reduced system of ECG leads was employed. Surface ECG mapping makes possible a more precise location of the preexcitation, which is of great clinical importance for the indication of surgical treatment, determination of prognosis and of working ability.

Published
1985

27. Use of selected quantitative parameters of the electric field of the heart in evaluating the presence and site of preexcitation.

Author

Cagán S, Filipová S, and Jurkovicová O

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Female, Heart physiopathology, Humans, Male, Middle Aged, Electrocardiography, Wolff-Parkinson-White Syndrome physiopathology
Abstract

Electrocardiographic methods play a decisive role in evaluation of the health condition of subjects with WPW pattern. The authors examined 54 patients with WPW pattern with different degrees of preexcitation. The presence of preexcitation and the localization of its focus was determined by surface electrocardiographic mapping using the original Czechoslovak computer equipment KARDIO-SMEP 01.0. The duration of ventricular activation was determined according to root mean square signals. By means of potential and temporo-spatial analysis of peak negative regions of instantaneous maps (in 2 ms intervals) they determined the duration of the period of proper preexcitation, of fusion of the two activation events, and of the end depolarization of the ventricles. In localizing the preexcitation focus they proceeded according to the criteria of Benson et al. (1982) with individual evaluation of quantitative preexcitation parameters of ECG maps and according to vector analysis of the delta wave. Quantitative and temporo-spatial evaluation of the mutual relationship of the two activation events in WPW pattern allows to establish reliably the presence, degree and focus localization of preexcitation even at a low degree of preexcitation and at a low-potential level of the preexcitation surface activity on ECG maps.

Published
1989

28. [Evaluation of the Q wave in leads II, III and aVF. II. Impulse conduction disorders , hypertrophy of the cardiac muscle, pre-excitation, focal and diffuse changes in the cardiac muscle and other causes].

Author

Cagán S, Kuchárová L, and Filipová S

Subjects
Humans, Pre-Excitation Syndromes physiopathology, Arrhythmias, Cardiac physiopathology, Cardiomegaly physiopathology, Cardiomyopathies physiopathology, Electrocardiography
Abstract

The authors present a brief account of contemporary findings in the literature on the evaluation of the Q wave in the electrocardiogram in leads II, III and aVF in disorders of the conduction of impulses (also combination with focal lesions of the heart muscle), in preexcitation of various extent, in hypertrophy and different focal and diffuse changes of the heart muscle. They mention briefly also other cardiac and extracardiac causes of the development and persistence of the Q wave in leads, II, III, aVF. They reached the main conclusion that isolated evaluation of this phenomenon only from the electrocardiogram can lead to erroneous conclusions, therefore they advocate comprehensive evaluation of the clinical condition of these patients (in indicated cases with extension of the range of ECG examinations by vectorcardiography and mapping of electric potentials of the heart on the body surface; echocardiography and scintigraphy may prove valuable).

Published
1989

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